05D2107979 CLIA NUMBER - FACECENTERLA, INC

Laboratory Demographics

  • CLIA Code: 05D2107979
  • Facility Name: FACECENTERLA, INC
  • Facility Address: 881 ALMA REAL DR STE 204
    PACIFIC PALISADES, CA
    ZIP 90272
  • Facility Phone: 310 857-2088
  • Facility Type: Other - OFFICE BASED SURGERY CTR
  • Facility Type: Waiver
  • Lab Director: DAVID W. DORFMAN, MD
  • NPI Number: 1023531258
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2107979
LAB Type Other - OFFICE BASED SURGERY CTR
Facility Name FACECENTERLA, INC
Street 881 ALMA REAL DR STE 204
City PACIFIC PALISADES
State CA
ZIP 90272
Phone 310 857-2088
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Other - OFFICE BASED SURGERY CTR
Lab Director DAVID W. DORFMAN, MD

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This page was last updated on: 9/29/2025